Abstract 128: Assessing the Temporal Trend in Survival to Hospital Admission Following Out-Of-Hospital Cardiac Arrest: Analysis From a Public Access Defibrillator Registry

Introduction: The AHA Get With the Guidelines Resuscitation Investigators recently identified that in-hospital cardiac arrest patients admitted during nights and weekends are less likely to survive to discharge. Our analysis aimed to determine if a similar relationship applied to out-of-hospital cardiac arrest (OHCA) patients. Methods: Worldwide data collection began in Oct 2012. Users of HeartSine SAM PAD public access defibrillators submitted electronic event data (comprising time/date of event and electrocardiogram traces) and an event report form (comprising patient demographics, location of arrest and survival to hospital outcome). First shock success was defined as termination of shockable rhythm for 5 seconds post-shock. Data was analysed using R. Results: A total of 3400 OHCA cases were collected. Median (IQR) age was 63 (50, 75) and males accounted for 72.4% of the dataset. A total of 1127 first shocks were delivered, and first shock success was 87.2% (983 shocks). Survival outcomes were reported in 2942 cases, and 783 (26.6%) patients survived to hospital admission. First shock success as a response to day of the week (weekday versus weekend [12am Saturday-11.59pm Sunday]) adjusted for patient age, gender and location of arrest, was assessed and there was no association found. When the same model was fitted with survival to hospital admission as a response to day of the week, it was determined that patients are approximately 20% less likely to survive to hospital admission at the weekend (OR=0.81, 95%CI [0.68, 0.95], p=0.01). There was a negative association between survival and OHCA occurring at home (OR=0.32, 95%CI [0.10, 0.94], p=0.03) and increasing age (per 1-year increase, OR=0.99, 95%CI [0.98, 1.00], p<0.001). Adjusting the model for time of day (morning [6am-11.59am], afternoon [12pm-5.59pm], evening [6pm-11.59pm] and night [12am-5.59am]) did not highlight an association with any particular time of day. Conclusions: OHCA patients are significantly less likely to survive to hospital admission at weekends compared to weekdays. Further analysis on the availability of PADs at professional and recreational locations and availability of trained medical rescuers at the weekend versus weekdays could account for the differences observed.

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The association between public access defibrillation and outcome in witnessed out-of-hospital cardiac arrest with shockable rhythm

Resuscitation ◽

10.1016/j.resuscitation.2019.05.017 ◽

2019 ◽

Vol 140 ◽

pp. 93-97 ◽

Cited By ~ 4

Author(s):

Kosuke Kiyohara ◽

Chika Nishiyama ◽

Tetsuhisa Kitamura ◽

Tasuku Matsuyama ◽

Junya Sado ◽

...

Keyword(s):

Cardiac Arrest ◽

Public Access ◽

Public Access Defibrillation ◽

Shockable Rhythm ◽

Hospital Cardiac Arrest

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Abstract 183: Public-Access Automated External Defibrillator Pad Application and Favorable Neurological Outcome After Out-of-Hospital Cardiac Arrest in Public Locations; A Prospective Population-Based Propensity-Score Matched Study

Circulation ◽

10.1161/circ.138.suppl_2.183 ◽

2018 ◽

Vol 138 (Suppl_2) ◽

Author(s):

Takefumi Kishimori ◽

Takeyuki Kiguchi ◽

Kosuke Kiyohara ◽

Tasuku Matsuyama ◽

Haruka Shida ◽

...

Keyword(s):

Cardiac Arrest ◽

Propensity Score ◽

Propensity Score Matching ◽

Neurological Outcome ◽

Public Access ◽

Automated External Defibrillator ◽

Shockable Rhythm ◽

Favorable Neurological Outcome ◽

Hospital Cardiac Arrest ◽

External Defibrillator

Background: Randomized control trials or observational studies showed that the use of public-access automated external defibrillator (AED) was effective for patients with out-of-hospital cardiac arrest (OHCA). However, it is unclear whether public-access AED use is effective for all patients with OHCA irrespective of first documented rhythm. We aimed to evaluate the effect of public-access AED use for OHCA patients considering first documented rhythm (shockable or non-shockable) in public locations. Methods: From the Utstein-style registry in Osaka City, Japan, we obtained information on adult patients with OHCA of medical origin in public locations before emergency-medical-service personnel arrival between 2011 and 2015. The primary outcome was one-month survival with favorable neurological outcome. Multivariable logistic regression analysis was used to assess the association between the public-access AED pad application and favorable neurological outcome after OHCA by using one-to-one propensity score matching analysis. Results: Among 1743 eligible patients, a total of 336 (19.3%) victims received public-access AED pad application. The proportion of patients who survived one-month with favorable neurological outcome was significantly higher in the pad application group than in the non-pad application group (29.8% vs. 9.7%; adjusted odds ratio [AOR], 2.85; 95% confidence interval [CI], 1.73-4.68, AOR after propensity score matching, 2.83; 95% CI, 1.40-5.72). In a subgroup analysis, the AOR of patients with shockable or non-shockable rhythms was 3.36 (95% CI, 1.78-6.35) and 2.38 (95% CI, 0.89-6.34), respectively. Conclusions: Public-access AED pad application was associated with better outcome among OHCA patients with shockable rhythm and the trend was the same among those with non-shockable rhythm.

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Abstract 146: Association of Epinephrine Prior to Defibrillation with Survival in Patients with In-hospital Cardiac Arrest

Circulation ◽

10.1161/circ.142.suppl_4.146 ◽

2020 ◽

Vol 142 (Suppl_4) ◽

Author(s):

Erin Evans ◽

Morgan B Swanson ◽

Nicholas Mohr ◽

Boulos Nassar ◽

Paul S Chan ◽

...

Keyword(s):

Cardiac Arrest ◽

Spontaneous Circulation ◽

First Line ◽

Lower Odds ◽

Return Of Spontaneous Circulation ◽

Shockable Rhythm ◽

Get With The Guidelines ◽

Current Guidelines ◽

Hospital Cardiac Arrest ◽

First Line Treatment

Background: Prompt defibrillation is a first line treatment for in-hospital cardiac arrest (IHCA) due to a shockable rhythm, with epinephrine recommended only when defibrillation is ineffective. However, empirical data regarding epinephrine prior to first defibrillation for shockable IHCA and its association with survival are unavailable. Methods: Using 2000-2018 Get with the Guidelines Resuscitation data, we identified adults ( > 18 years) with an index IHCA due to an initial shockable rhythm. We conducted a time-dependent propensity-matched analysis to evaluate the association of epinephrine prior to first defibrillation with survival to discharge and acute resuscitation survival (i.e., return of spontaneous circulation for > 20 minutes). Results: Among 34,688 subjects, 10,057 (29.0%) received epinephrine before defibrillation. Median age was 67 years in both groups. Compared to defibrillation first, patients in the epinephrine first group were less likely to have myocardial infarction or heart failure, but more likely to have renal failure, sepsis and pneumonia, be located in an intensive care unit, and already receiving mechanical ventilation (P <0.001 for all). Treatment with epinephrine first was strongly associated with a delay in first defibrillation (median 3 min vs. 0 min; P <0.001). In propensity-matched analysis, epinephrine prior to defibrillation was associated with lower odds of survival to discharge (OR: 0.81, 95% CI 0.76 - 0.86) and acute resuscitation survival (OR: 0.79, 95% CI 0.74 - 0.84). Early epinephrine was associated with lower survival (OR: 0.87, 95% CI 0.78-0.97) and acute resuscitation survival (OR for acute resuscitation survival: 0.83, 95% CI 0.74-0.93) even in patients who received defibrillation within 2 minutes. Conclusions: Despite a strong emphasis on prompt defibrillation in current guidelines, nearly 1 in 3 patients with IHCA due to a shockable rhythm received epinephrine prior to first defibrillation. Epinephrine before defibrillation was associated with worse survival outcomes. Although delays in defibrillation were more common in the early epinephrine group, early epinephrine remained associated with worse outcomes even in patients who received prompt defibrillation.

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Impact of the COVID-19 pandemic on the epidemiology of out-of-hospital cardiac arrest: A systematic review and meta-analysis

10.21203/rs.3.rs-788944/v1 ◽

2021 ◽

Author(s):

Seth En Teoh ◽

Yoshio Masuda ◽

Darren Jun Hao Tan ◽

Nan Liu ◽

Laurie J. Morrison ◽

...

Keyword(s):

Cardiac Arrest ◽

Hospital Admission ◽

Case Fatality Rate ◽

Clinical Characteristics ◽

Case Fatality ◽

Cochrane Library ◽

Fatality Rate ◽

Shockable Rhythm ◽

The Impact ◽

Hospital Cardiac Arrest

Abstract Background The coronavirus disease 2019 (COVID-19) pandemic has significantly influenced epidemiology, yet its impact on out-of-hospital cardiac arrest (OHCA) remains unclear. We aimed to evaluate the impact of the pandemic on the incidence and case fatality rate (CFR) of OHCA. We also evaluated the impact on intermediate outcomes and clinical characteristics. Methods PubMed, EMBASE, Web of Science, Scopus, and Cochrane Library databases were searched from inception to May 3, 2021. Studies were included if they compared OHCA processes and outcomes between the pandemic and historical control time periods. Meta-analyses were performed for primary outcomes (annual incidence, mortality, and case fatality rate [CFR]), secondary outcomes (field termination of resuscitation [TOR], return of spontaneous circulation [ROSC]), survival to hospital admission, and survival to hospital discharge), and clinical characteristics (shockable rhythm and etiologies). This study was registered in the International Prospective Register of Systematic Reviews (PROSPERO) (CRD42021253879). Results The COVID-19 pandemic was associated with a 39.5% increase in pooled annual OHCA incidence (p < 0.001). Pooled CFR was increased by 2.65% (p < 0.001), with a pooled odds ratio (OR) of 1.95 for mortality (95% confidence interval [95%CI] 1.51–2.51). There was increased field TOR (OR = 2.46, 95%CI 1.62–3.74). There were decreased ROSC (OR = 0.65, 95%CI 0.55–0.77), survival to hospital admission (OR = 0.65, 95%CI 0.48–0.89), and survival to discharge (OR = 0.52, 95%CI 0.40–0.69). There was decreased shockable rhythm (OR = 0.73, 95%CI 0.60–0.88) and increased asphyxial etiology of OHCA (OR = 1.17, 95%CI 1.02–1.33). Conclusion Compared to the pre-pandemic period, the COVID-19 pandemic period was significantly associated with increased OHCA incidence and worse outcomes.

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Abstract 254: High Shock Efficacy and Algorithm Performance for a 150J Biphasic Waveform AED Used by Lay and BLS Responders During Out-of-hospital Cardiac Arrest

Circulation ◽

10.1161/circ.142.suppl_4.254 ◽

2020 ◽

Vol 142 (Suppl_4) ◽

Author(s):

Stacy Gehman ◽

Edward Kompare ◽

Barbara Fink ◽

Tim Johnson ◽

Walter Hufford ◽

...

Keyword(s):

Cardiac Arrest ◽

Normal Sinus Rhythm ◽

Convenience Sample ◽

Shock Delivery ◽

Shockable Rhythm ◽

Normal Sinus ◽

High Shock ◽

Biphasic Waveform ◽

Post Shock ◽

Hospital Cardiac Arrest

Introduction: Effective AED defibrillation of out of hospital cardiac arrest (OHCA) depends on the safe and effective identification of shockable rhythms, and on delivery of effective defibrillation energy. This report summarizes rhythm detection performance and shock efficacy during OHCA uses of Philips HeartStart Home and OnSite AEDs using non-escalating 150 J therapy. Methods: A convenience sample of 185 OHCA AED patient uses were reviewed by clinical experts. All analysis periods that resulted in AED rhythm advisories (Shock Advised or No Shock Advised) were annotated. Shockable rhythm categories include VF and polymorphic VT/flutter. Non-Shockable rhythm categories include normal sinus rhythm, other rhythms (e.g., atrial fibrillation/flutter, bradycardia, SVT, idioventricular, bundle branch block), and asystole. Intermediate rhythms (benefits of defibrillation are limited or uncertain) were not included. Post-shock rhythm was categorized as shockable, non-shockable, or undeterminable (rhythms corrupted by CPR artifact or pads removal within 5-s of shock delivery). Shock success was defined as conversion to a non-shockable rhythm within 5-s post-shock. Results: A total of 487 analysis periods resulted in AED rhythm advisories, with 175 annotated as Shockable and 312 Non-shockable. Sensitivity and specificity (n/N, Exact 95% CI) were 97.7% (171/175, 94.3%, 99.4%) and 100% (312/312, 98.8%, 100.0%) respectively. A total of 165 shocks were delivered to 100 patients with 5 undeterminable post-shock rhythms. The remaining 160 shocks were delivered to 156 Shockable rhythm episodes. All shock efficacy was 96.9% (155/160, 92.9%, 99.0%): 150 episodes converted to non-shockable rhythms after one shock (96.2% (150/156, 91.8%, 98.6%)); 154 after two shocks (98.7% (154/156, 95.4%, 99.8%)); and 155 after three shocks, the first two of which were undeterminable (99.4% (155/156, 96.5%, 100.0%)). The remaining episode had a failed first shock, followed by an undeterminable second shock, which was the last shock of the use. Conclusion: For these 150J fixed-energy AEDs, OHCA defibrillation is safe (100% specificity), and effective (97.7% sensitivity; 96.2% single shock effectiveness; 98.7% after two shocks; 99.4% after three shocks).

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Abstract 207: The Prevalence and Significance of Abnormal Vital Signs Prior to In-Hospital Cardiac Arrest

Circulation ◽

10.1161/circ.130.suppl_2.207 ◽

2014 ◽

Vol 130 (suppl_2) ◽

Author(s):

Won Young Kim ◽

Lars W Andersen ◽

Sharri Mortensen ◽

Maureen Chase ◽

Katherine Berg ◽

...

Keyword(s):

Cardiac Arrest ◽

Vital Sign ◽

Multivariable Analysis ◽

Vital Signs ◽

National Registry ◽

Patient Demographics ◽

Get With The Guidelines ◽

Hospital Wards ◽

Hospital Cardiac Arrest ◽

Overall Mortality

Background: The association between vital sign abnormalities prior to cardiac arrest and outcome has not been previously reported. In this study we investigated the prevalence of abnormal vital signs prior to in-hospital cardiac arrest and the association with mortality Methods: We utilized the Get With the Guidelines - Resuscitation national registry to identify adult patients with an in-hospital cardiac arrest between 2007-2010. We included index events and excluded patients with missing data on vital signs within 1-4 hours prior to arrest. We evaluated the prevalence of abnormal vital signs classified as mild, moderate or severe (Table 1). We determined the association between the number of abnormal vital signs per patient and in-hospital mortality using multivariate logistic regression with adjustment for multiple potential confounders including patient demographics and co-morbid conditions. Results: A total of 9,560 patients were included. Median age was 71 (60 - 81) years, 42% were female and overall mortality was 77%. The prevalence of vital sign abnormalities is shown in Table 1. As illustrated in Figure 1 we found a step-wise increase in mortality with increasing number of abnormal vital signs that remained in multivariable analysis across all categories (Mild: adjusted OR 1.37 [CI: 1.27 - 1.48], Moderate: adjusted OR 1.53 [CI: 1.35 - 1.73] and Severe: adjusted OR 1.43 [CI: 1.21 - 1.70], all p-values < 0.0001). Conclusion: Abnormal vital signs are common within four hours before cardiac arrest on in-hospital wards. Our study demonstrates incremental increases in mortality with both increasing number of pre-arrest abnormal vital signs as well as increased severity.

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Abstract 18274: Comparative Effectiveness of Stacked versus Single Shock Therapy for In-Hospital Cardiac Arrest: Insights from the Get With the Guidelines-Resuscitation Registry

Circulation ◽

10.1161/circ.130.suppl_2.18274 ◽

2014 ◽

Vol 130 (suppl_2) ◽

Author(s):

Steven M Bradley ◽

Wenhui Liu ◽

Gary K Grunwald ◽

Paul S Chan ◽

Brahmajee K Nallamothu ◽

...

Keyword(s):

Cardiac Arrest ◽

Temporal Trends ◽

Shock Therapy ◽

Hierarchical Regression ◽

Time Interval ◽

Single Shock ◽

Post Shock ◽

Initial Shock ◽

Get With The Guidelines ◽

Hospital Cardiac Arrest

Background: Among patients with cardiac arrest due to ventricular tachycardia or ventricular fibrillation (VT/VF), guidelines emphasize single shock protocols to minimize interruptions in chest compressions that may impair patient outcomes. The adoption and impact of single shock protocols on survival of in-hospital VT/VF arrest is unknown. Methods: In the Get With The Guidelines - Resuscitation multicenter observational registry, we identified 4,114 adults with in-hospital cardiac arrest due to VT/VF between 2004 and 2012, an immediate post-shock rhythm of VT/VF following the initial defibrillation attempt, and a second defibrillation attempt within 3 minutes of the first shock. The time interval in minutes from the initial shock to second shock was used to define stacked shock (time interval of 0 to 1 minute) and single shock protocols (time interval of 2 to 3 minutes). We first evaluated temporal trends in the use of stacked versus single shock protocols. We then used hierarchical regression adjusting for patient arrest characteristics and comorbidities while accounting for clustered observations by hospital to determine the association between stacked versus single shocks for VT/VF and survival to discharge. For this analysis, we restricted our cohort to the 2,984 (72.5%) patients with VT/VFarrest occurring at one of 150 hospitals with the use of both stacked and single shock approaches and at least 10 events during the study period. Results: The proportion of patients receiving a single shock protocol for VT/VF following an initial defibrillation attempt doubled from 25% in 2004 to more than 50% in 2012. Compared with patients treated with stacked shocks, treatment with single shocks was associated with a lower risk-adjusted survival to discharge (odds ratio 0.81, 95% confidence interval 0.68 to 0.98, P=0.03). Conclusion: Among adults with in-hospital VT/VFarrest, use of single shocks has increased since 2004 in accordance with guideline recommendations. However, compared with stacked shocks, single shocks for VT/VF was associated with decreased odds of survival to discharge. These observational findings suggest further investigation is needed to define the optimal defibrillation strategy for management of in-hospital VT/VF arrest.

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Impact of the COVID-19 pandemic on the epidemiology of out-of-hospital cardiac arrest: a systematic review and meta-analysis

Annals of Intensive Care ◽

10.1186/s13613-021-00957-8 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Seth En Teoh ◽

Yoshio Masuda ◽

Darren Jun Hao Tan ◽

Nan Liu ◽

Laurie J. Morrison ◽

...

Keyword(s):

Cardiac Arrest ◽

Hospital Admission ◽

Case Fatality Rate ◽

Clinical Characteristics ◽

Case Fatality ◽

Cochrane Library ◽

Fatality Rate ◽

Shockable Rhythm ◽

The Impact ◽

Hospital Cardiac Arrest

Abstract Background The coronavirus disease 2019 (COVID-19) pandemic has significantly influenced epidemiology, yet its impact on out-of-hospital cardiac arrest (OHCA) remains unclear. We aimed to evaluate the impact of the pandemic on the incidence and case fatality rate (CFR) of OHCA. We also evaluated the impact on intermediate outcomes and clinical characteristics. Methods PubMed, EMBASE, Web of Science, Scopus, and Cochrane Library databases were searched from inception to May 3, 2021. Studies were included if they compared OHCA processes and outcomes between the pandemic and historical control time periods. Meta-analyses were performed for primary outcomes [annual incidence, mortality, and case fatality rate (CFR)], secondary outcomes [field termination of resuscitation (TOR), return of spontaneous circulation (ROSC), survival to hospital admission, and survival to hospital discharge], and clinical characteristics (shockable rhythm and etiologies). This study was registered in the International Prospective Register of Systematic Reviews (PROSPERO) (CRD42021253879). Results The COVID-19 pandemic was associated with a 39.5% increase in pooled annual OHCA incidence (p < 0.001). Pooled CFR was increased by 2.65% (p < 0.001), with a pooled odds ratio (OR) of 1.95 for mortality [95% confidence interval (95%CI) 1.51–2.51]. There was increased field TOR (OR = 2.46, 95%CI 1.62–3.74). There were decreased ROSC (OR = 0.65, 95%CI 0.55–0.77), survival to hospital admission (OR = 0.65, 95%CI 0.48–0.89), and survival to discharge (OR = 0.52, 95%CI 0.40–0.69). There was decreased shockable rhythm (OR = 0.73, 95%CI 0.60–0.88) and increased asphyxial etiology of OHCA (OR = 1.17, 95%CI 1.02–1.33). Conclusion Compared to the pre-pandemic period, the COVID-19 pandemic period was significantly associated with increased OHCA incidence and worse outcomes.

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Epinephrine before defibrillation in patients with shockable in-hospital cardiac arrest: propensity matched analysis

BMJ ◽

10.1136/bmj-2021-066534 ◽

2021 ◽

pp. e066534

Author(s):

Erin Evans ◽

Morgan B Swanson ◽

Nicholas Mohr ◽

Nassar Boulos ◽

Mary Vaughan-Sarrazin ◽

...

Keyword(s):

Cardiac Arrest ◽

Cerebral Performance Category ◽

Spontaneous Circulation ◽

Sensitivity Analyses ◽

Shockable Rhythm ◽

History Of ◽

Independent Association ◽

Get With The Guidelines ◽

Current Guidelines ◽

Hospital Cardiac Arrest

Abstract Objective To determine the use of epinephrine (adrenaline) before defibrillation for treatment of in-hospital cardiac arrest due to a ventricular arrhythmia and examine its association with patient survival. Design Propensity matched analysis. Setting 2000-18 data from 497 hospitals participating in the American Heart Association’s Get With The Guidelines-Resuscitation registry. Participants Adults aged 18 and older with an index in-hospital cardiac arrest due to an initial shockable rhythm treated with defibrillation. Interventions Administration of epinephrine before first defibrillation. Main outcome measures Survival to discharge; favorable neurological survival, defined as survival to discharge with none, mild, or moderate neurological disability measured using cerebral performance category scores; and survival after acute resuscitation (that is, return of spontaneous circulation for >20 minutes). A time dependent, propensity matched analysis was performed to adjust for confounding due to indication and evaluate the independent association of epinephrine before defibrillation with study outcomes. Results Among 34 820 patients with an initial shockable rhythm, 9630 (27.6%) were treated with epinephrine before defibrillation, contrary to current guidelines. In comparison with participants treated with defibrillation first, participants receiving epinephrine first were less likely to have a history of myocardial infarction or heart failure, but more likely to have renal failure, sepsis, pneumonia, and receive mechanical ventilation before in-hospital cardiac arrest (P<0.0001 for all). Treatment with epinephrine before defibrillation was strongly associated with delayed defibrillation (median 3 minutes v 0 minutes). In propensity matched analysis (9011 matched pairs), epinephrine before defibrillation was associated with lower odds of survival to discharge (25.2% v 29.9%; adjusted odds ratio 0.81, 95% confidence interval 0.74 to 0.88; P<0.001), favorable neurological survival (18.6% v 21.4%; 0.85, 0.76 to 0.92; P<0.001), and survival after acute resuscitation (64.4% v 69.4%; 0.76, 0.70 to 0.83; P<0.001). The above findings were consistent in a range of sensitivity analyses, including matching according to defibrillation time. Conclusions Contrary to current guidelines that prioritize immediate defibrillation for in-hospital cardiac arrest due to a shockable rhythm, more than one in four patients are treated with epinephrine before defibrillation, which is associated with worse survival.

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Epidemiology of in-hospital cardiac arrest in Abu Dhabi, United Arab Emirates, 2013–2015

Heart Asia ◽

10.1136/heartasia-2018-011029 ◽

2018 ◽

Vol 10 (2) ◽

pp. e011029 ◽

Cited By ~ 2

Author(s):

Faisal Aziz ◽

Marilia Silva Paulo ◽

Emad H Dababneh ◽

Tom Loney

Keyword(s):

Cardiac Arrest ◽

United Arab Emirates ◽

Hospital Admissions ◽

Tertiary Care ◽

Time Of Day ◽

Abu Dhabi ◽

Survival Outcomes ◽

Care Hospital ◽

Shockable Rhythm ◽

Hospital Cardiac Arrest

ObjectiveEstimate the incidence and outcomes of in-hospital cardiac arrest (IHCA) in a tertiary-care hospital in Abu Dhabi emirate, United Arab Emirates (UAE).MethodsRetrospective data from 685 inpatients who experienced an IHCA at a hospital in Abu Dhabi (UAE) between 1 January 2013 and 31 December 2015 were analysed. Sociodemographic variables were age and gender, and IHCA event variables were shift, day, event location, initial cardiac rhythm and the total number of IHCA events. Outcome variables were the return of spontaneous circulation (ROSC) and survival to discharge (StD).ResultsThe incidence of IHCA was 11.7 (95% CI 10.8 to 12.6) per 1000 hospital admissions. Non-shockable rhythms were 91.1% of the cardiac rhythms at presentation. The majority of IHCA cases occurred in the intensive care unit (46.1%) and on weekdays (74.6%). More than a third (38.3%) of patients who experienced an IHCA achieved ROSC and 7.7% StD. Both ROSC and StD were significantly higher in patients who were younger and presenting with a shockable rhythm (all p’s≤0.05). Survival outcomes were not significantly different between dayshifts and nightshifts or weekdays and weekends.ConclusionsThe incidence of IHCA was higher and its outcomes were lower compared with other high-income/developed countries. Survival outcomes were better for patients who were younger and had a shockable rhythm, and similar between time of day and days of the week. These findings may help to inform health managers about the magnitude and quality of IHCA care in the UAE.

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